You are a general practitioner and are reviewing a four year old boy. His mother is worried that he is looking rather pale and has been unusually tired and off his food. He has a sore throat and occasional fever over the last week. He had been given paracetamol with occasional ibuprofen for presumed viral infection which seemed to help. He has just started school and numerous infections had been ‘going around’. When you see the child he is very pale and allows you to examine him fully without much complaint.

Questions:

What would you be looking for on examination of this child?

Is there anything else in the history you’d like to know?

What is your next move?

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